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Pan-enteric dysmotility,impaired quality of life and alexithymia in a large group of patients meeting ROMEⅡ criteria for irritable bowel syndrome

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World Journal of Gastroenterology 2003年第10期9卷 2293-2299页

作者： Piero Portincasa Antonio Moschetta giuseppe baldassarre Donato F. Altomare giuseppe Palasciano Section of Internal Medicine Department of Internal Medicine and Public Medicine(DIMIMP)University Medical SchoolBari Division of Geriatrics Hospital"Miulli"Acquaviva delle FontiBariItaly Section of-Surgery Department of Emergency and Organ Transplant(DETO)University Medical SchoolBariItaly

AIM:Psychological factors, altered motility and sensation disorders of the intestine can be variably associated with irritable bowel syndrome (IBS). Such aspects have not been investigated simultaneously. The aim of this paper was to evaluate gastrointestinal motility and symptoms, psychological spectrum and quality of life in a large group of IBS patients in southern ***: One hundred IBS patients (F:M=73:27, age 48±2 years, mean±SE) fulfilling ROME Ⅱ criteria matched with 100 healthy subjects (F:M=70:30, 45±2 years). Dyspepsia,bowel habit, alexithymia, psycho-affective profile and quality of life were assessed using specific questionnaires. Basally and postprandially, changes in gallbladder volumes and antral areas after liquid meal and orocaecal transit time (OCTT)were measured respectively by ultrasonography and H2-breath test. Appetite, satiety, fullness, nausea, and epigastric pain/discomfort were monitored using visual-analogue ***: Compared with controls, IBS patients had increased dyspepsia (score 12.6±0.7 VS 5.1±0.2, P＜0.0001),weekly bowel movements (12.3±0.4 VS 5.5±0.2, P＜0.00001, comparable stool shape), alexithymia (score 59.11.1 VS40.5±1.0, P=0.001), poor quality of life and psychoaffective profile. IBS patients had normal gallbladderemptying, but delayed gastric emptying (T50:35.5±1.0 VS 26.1±0.6 min, P=0.00001) and OCTT (163.0±5.4 VS96.6±1.8min, P=0.00001). Fullness, nausea, and epigastric pain/discomfort were greater in IBS than in ***: ROME Ⅱ IBS patients have a pan-enteric dysmotility with frequent dyspepsia, associated with psychological morbidity and greatly impaired quality of *** presence of alexithymia, a stable trait, is a novel finding of potential interest to detect subgroups of IBS patients with different patterns recoveed after therapy.

关键词：肠易激综合征述情障碍生活质量临床研究

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Impaired gallbladder motility and delayed orocecal transit contribute to pigment gallstone and biliary sludge formation in β-thalassemia major adults

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World Journal of Gastroenterology 2004年第16期10卷 2383-2390页

作者： PieroPortincasa AntonioMoschetta MassimoBerardino Agostino Di Ciaula Michele Vacca giuseppe baldassarre AnnaPietrapertosa RosarioCammarota NunziaTannoia giuseppe Palasciano Section of Internal Medicine Department of Internal Medicine and Public Medicine (DIMIMP)University Medical SchoolBariItaly Division of Internal Medicine Hospital of BisceglieItaly Division Chair

AIM: Gallbladder and gastrointestinal motility defects exist in gallstones patients and to a lesser extent in pigment gallstone patients. To investigated the role of gallbladder and gastrointestinal motility disorders in pigment gallstoneformation in β-thalassemia ***: Twenty-three patients with β-thalassemia major (16 females; age range 18-37 years) and 70 controls (47 females, age range 18-40 years) were studied for gallbladder and gastric emptying (functional ultrasonography),orocecal transit (OCTT, H2-breath test), autonomic dysfunction (sweat-spot, cardiorespiratory reflex tests),bowel habits, gastrointestinal symptoms and quality of life (all with questionnaires). Gallbladder content (ultrasonography) was examined before and during 8-12 mo ***: Gallstones and/or biliary sludge were found in 13 (56%) patients. β-thalassemia major patients had increased fasting (38.04-4.8 mL vs 20.3±0.7 mL, P= 0.0001) and residual (7.94-1.3 mL vs 5.1±0.3 mL, P= 0.002) volumeb and slightly slower emptying (24.94±2.7 min vs20.2±0.7 min,P = 0.04) of the gallbladder, together with longer OCTT(232.24±7.8 rain vs99.7±2.3 rain, P= 0.00003) than *** differences in gastric emptying and bowel habits were found. Also, patients had higher dyspepsia (score: 6.74-1.2vs 4.94-0.2, P = 0.027), greater appetite (P = 0.000004) and lower health perception (P = 0.00002) than *** dysfunction was diagnosed in 52% of patients (positive tests: 76.2% and 66.7% for parasympathetic and sympathetic involvement, respectively). Patients developing sludge during follow-up (38%, 2 with prior stones) had increased fasting and residual gallbladder ***: Adult β-thalassemia major patients have gallbladder dysmotility associated with delayed small intestinal transit and autonomic dysfunction. These abnormalities apparently contribute together with haemolytic hyperbilirubinemia to the pathogenesis of pigment gallstones/sludge in β-thalassemia major.

关键词：胆囊运动性转接色素胆石症胆汁淤积 β-地中海贫血症成年人胃肠运动

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